Strategies for Managed Care Contracting
Managed Care contracts can form a complicated and confusing maze, made ever more complex by the continuing expansion of provider networks and the rapidly increasing number of enrolled members. Operational and administrative responsibilities, as well as the extent of financial risk assumed by a medical provider, must be carefully evaluated.
As a first step, persons considering a relationship with a managed care health plan or third party payer should review the strategies to be considered in contract formulation, analyze the companies or organizations that might become partners, and assess how the relationship will evolve.
Other important items to keep in mind when considering a contract relationship with a managed care health plan or third party payer include the following:
